Frequency of serum low-density lipoprotein cholesterol measurement and frequency of results <= 100 mg/dl among patients who had coronary events (Northwest VA Network study)

This population-based, cross-sectional analysis targeted all veterans with coronary heart disease (CHD) who were active patients in primary care or ca rdiology clinics in the Veterans Health Administration Northwest Network fr om July 1998 to June 1999. We report guideline compliance rates, including whether low-density lipoprotein (LDL) was measured, and if measured, whethe r the LDL was less than or equal to 100 mg/dl. In addition, we utilized mul tivariate logistic regression to determine patient characteristics associat ed with LDL measurements and levels. Of 13,891 active patients with CHD, 5, 552 (40.0%) did not have a current LDL measurement. Of those with LDL measu rements, 39.1% were at the LDL goal of less than or equal to 100 mg/dl, whe reas 26.5% had LDL greater than or equal to 130 mg/dl. Male gender, younger age, history of angioplasty or coronary artery bypass grafting, current hy pertension, diabetes mellitus, and angina pectoris were associated with inc reased likelihood of LDL measurement. Older age and current diabetes and an gina were associated with increased likelihood of LDL being less than or eq ual to 100 mg/dl, if measured. Although these rates of guideline adherence in the CHD population compare well to previously published results, they co ntinue to be unacceptably low for optimal clinical outcomes. Attention to b oth LDL measurement and treatment (if elevated) is warranted. (C) 2001 by E xcerpta Medica, Inc.